Residusal significant tricuspid regurgitation after mitral valve operation may significantly increase postoperative morbidity and mortality. However, routine techniques to 3) detect tricuspid regurgitation preoperatively and pos .operatively are not accurate. Doppler echocardiography was performed preoperatively and postoperatively to assess its ability to evaluate and quantify the severity of tricuspid regurgitation.
In 34 patients with tricuspid regurgitation secondary to mitral valvular disease the tricuspid regurgitation were semiquantified on a scale of 1 to 3+. The 34 patients were divided into two groups on the basis of severity of tricuspid regurgitation as assessed by pro-ck perative Doppler echocardiography. Group I (8 patients) had mild(1+) regurgitation, and group II (26 patients) had moderate to severe (23+) tricuspid regurgitation.
In all studied patients, preoperative Doppler echocardiographic studies for the degree of tricuspid regurgitation were correlated with clinical symptoms (including NYHA class) and hemodynamics(JVP and right ventricular systolic pressure), and used as the indicator to determine whether tricuspid annuloplasty should be performed or not.
Patients with significant tricuspid regurgitation(group 11) had greater preoperative right ventricular systolic pressures and NYHA classes, although there was no correlation between them.
The 8 patients with mild(1+) tricuspid regurgitation (group I ) didn´t undergo any procedure for the tricuspid regurgitation and their postoperative Doppler echocardiographic studies showed the less than mild(01+) tricuspid regurgitation, and the 26 patients with significant 02+) tricuspid regurgitation, and the 26 patients with significant 02+) tricuspid regurgitation (group U) underwent tricuspid annuloplasty for the tricuspid regurgitation and the postoperative Doppler echocardiographic studies showed the findings similar to group I except 1 patient who underwent Carpentier´s ring annuloplasty and had severe right ventricular failure.
Therefore, preoperative Doppler echocardiography can accurately assess the relative severity of tricuspid regurgitation. Importantly, postoperative Doppler echocardiography could conveniently determine the effect of tricuspid annuloplasty for the patients with significant tricuspid regurgitation. Doppler echocardiography may be an importan diagnostic method both for evaluating the degree of residual tricuspid regurgitation after left heart operation as well as for determining which patients should undergo tricuspid valve repair.
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